Smart card licenses and enforced quotas proposed to combat smoking

If you quit smoking, you get your license fees back—plus interest.

A public health professor has published a paper proposing that smokers be forced to apply for licences and given weekly quotas.

In his paper, published in PLOS Medicine, Simon Chapman of the University of Sydney's School of Public Health says that by issuing every smoker with a paid-for smartcard to buy cigarettes, governments will be able to gather data the health authorities can then use in anti-smoking campaigns.

Every time they buy a pack of cigarettes the smart card will need to be swiped and, depending on what annual license level the individual has purchased, the numbers will be totted up and they will be cut off when they reach their maximum weekly limit (70 per week, 140 per week or 350 per week). The higher the limit, the more the licence will cost, deterring, says Chapman, lower-income individuals: "Poor smokers, as a group, are known to be more responsive to price than those on higher incomes, in terms of both quitting and reducing use." This may perturb the world's one billion smokers, 80 percent of which, according to the World Health Organisation, reside in low- and middle-income countries.

Chapman's argument is based on a pretty simplistic premise: if we need prescriptions to get hold of potentially harmful or addictive drugs, why don't cigarettes fall into this category?

"The prescription system is in effect a system of temporary licencing to use restricted substances," he writes in the paper. "Travellers carrying restricted drugs across borders can be required to show that they have a 'licence' to be in possession of some drugs… By contrast, tobacco products can be sold by any retailer… smokers can buy unlimited quantities of tobacco. Many nations outlaw sales to minors, but prosecutions are rare and sales to children common. In contrast to the highly regulated way we allow access to life-saving and health-enhancing pharmaceuticals, this is how we regulate access to a product that kills half its long-term users."

Based on the fact that smoking kills almost six million people each year, it should fall into the same category as things like firearms and fireworks, which are heavily restricted, argues Chapman. Sheer inconvenience and cost will not be the only deterrents of this system—Chapman calls the license fee "neither trivial nor astronomical... set at a sufficient level to give smokers some pause."

Most users will sign up online, and once their contact details have been obtained, anti-smoking messages of encouragement will be e-mailed to the user. There will also be financial incentives to stop smoking—if a user decides not to renew their license, they will be given back all the fees they paid to date, with interest. There should also be a critical cut-off point for this, so people give pause for thought about the financial burden of not giving up. New smokers, those turning 18, will have to take a "knowledge of risk test" before being granted a licence.

Chapman is not so naïve as to think there would not be a minor public outcry from smokers and sceptics alike, so although he touches on issues such as black market up-take, he has also asked Jeff Collin, political scientist and director of the Global Public Health Unit, to respond.

In Collin's "The Case against a Smoker's License," he argues that in some countries it would be a totally impractical system—for instance, in the UK, where "successive governments have failed to introduce identity cards."

"If it's very difficult to envisage health advocates securing support for a comparable scheme on the basis of a public health rationale, it is still harder to see why they should wish to."

His paper also suggests Chapman's strategy would make smokers feel like registered addicts, stigmatising the habit and creating demeaning scenarios for low income individuals: "The proposal to require licences will inevitably be widely perceived as demeaning, onerous, and punitive, and in explicitly targeting smokers would dramatically exacerbate the sense that smoking 'just has that sort of feel about it, a leper.'"

Collin does, however, agree that Chapman's argument of raising the legal smoking age by one year, every year, is worth consideration. He also concedes that there should be some restrictions on sales, considering some studies into hours of sale suggest putting restrictions in place could have a great effect.

"It is indeed an historical absurdity that so dangerous a product should be so readily available," he writes, but the rigidity of Champan's system is probably not the answer. Rather, Collin wants more creative and innovative techniques that look to undo the very nature of the mass manufacturing and promotion of tobacco we have all come to accept. Aside from the aforementioned tweaks to the system, Collin doesn't appear to have an alternative, however.

Completely changing the rules of the game halfway through has not proven effective in the past. For instance, in Bhutan the government attempted to enforce an outright ban on the sale of tobacco in 2005. However, by 2009 the authorities were already debating the bill after smuggling cigarettes became big business. It's also probably not good for the country's community relations when it threatens to jail a Buddhist monk for five years for being in possession of chewing tobacco.

152 Reader Comments

So wait the answer to stopping smoking is to create a punitive pay system where only people who are well off can afford to smoke?

And how does this actually stop people from smoking? Because if trying to stop drug use by making it punitive to use them didn't have the intended effect of curtailing usage and making narcotic more expensive/harder to obtain I don't see how this will. All this will do is create an avenue to create a black market for cigs.

This idea is the most ridiculous thing I have ever heard. It didn't work with narcotics (albeit it is a different tactic, but the same intended outcome, make drugs harder to get) it won't work with nicotine. It's a chemically addictive substance; people will do anything to get their fix.

More rich people will die sooner leaving the meek to inherit the earth. Also if you get sick and are found it was caused by smoking and you did not have a smoking card then you are denied treatment unless you can pay for it yourself. Of course now the smoking card becomes the Health card. So now we can also include drinking and eating sugars, getting fat etc. on the same card.

The point is that smoking, combined with some genetic combinations, leads to cancer. I'm all for personal freedom, but I think it's pretty obvious that smoking is more dangerous than not smoking. Until we get better at figuring EXACTLY what causes smokers' cancers, the best we can do is point at the smoke.

You do get that your logic can be applied to all kinds of things right? Peanuts can kill many people who are allergic to them. Shall we force people to stop eating them? Hell, simply being fat brings with it many potential medical complications as well. What leads to being fat? Eating too much food. Shall we strictly control what and how people eat? C'mon you are using bad logic to support a bad idea. Face the truth here. This is about personal freedom plain and simple.

So wait the answer to stopping smoking is to create a punitive pay system where only people who are well off can afford to smoke?

And how does this actually stop people from smoking? Because if trying to stop drug use by making it punitive to use them didn't have the intended effect of curtailing usage and making narcotic more expensive/harder to obtain I don't see how this will. All this will do is create an avenue to create a black market for cigs.

This idea is the most ridiculous thing I have ever heard. It didn't work with narcotics (albeit it is a different tactic, but the same intended outcome, make drugs harder to get) it won't work with nicotine. It's a chemically addictive substance; people will do anything to get their fix.

More rich people will die sooner leaving the meek to inherit the earth. Also if you get sick and are found it was caused by smoking and you did not have a smoking card then you are denied treatment unless you can pay for it yourself. Of course now the smoking card becomes the Health card. So now we can also include drinking and eating sugars, getting fat etc. on the same card.

This would be great for Obama Care.

That sounds an awful lot like people being denied basic medical treatment because they don't have insurance.

Calling the tobacco tax hugely lucrative for the government is disingenuous. The amount of revenue collected from the tobacco tax is less than 1% of total tax revenues. And what revenue is collected is largely a zero sum game as it mostly goes to offset the public health costs smokers create.

Are you sure about that ? Where I live tobacco taxes are 9 billion revenue for government each year.

Even if the cost of every EPOC, cerebral vascular accident, cancer, and asthmas in the country were due to tobacco, the government would have 6 billion to spare.

And we have universal public health so if you have cancer 100% of the treatment expenses goes to Government - I mean it's not the are getting the money and people have to go to private hospitals, the tobacco taxes covers for it all.

If you want to quit smoking good for you. If you don't wanna quit smoking that's great too. The religious zeal with which so many attack the smoking issue is insane to me. There really isn't any credible data which shows a definite link between smoking and cancer. There's isn't even any that can show a define link between 2nd hand smoke and cancer. This is why the American Cancer Association will never say if you smoke you will get cancer. They always use the qualifier 'may' when speaking on this topic. I don't get why weed is illegal yet Alcohol and tobacco aren't. Fact is there are plenty of people who have been life long smokers who NEVER developed cancer. Also, there are plenty of lifelong non-smokers who develop lung cancer and other cancers traditionally attributed to smoking.

...I've always be impressed with how generous smokers are with other smokers. If a smoker goes up to another, total stranger, and asks for a cigarette, 9 times out of 10 they will comply. I mean, you wouldn't go up to a total stranger and ask if they can spare a sandwich, but asking for a cigarette is somehow socially acceptable...

It's considered acceptable because it's a NEED. If you were among the people of southern Libya, or the desert regions of Afghanistan, and you asked a stranger for a cup of water or a place to stay, they would certainly help you — it's woven into the honour system of the culture, because it's a NEED. Smoking is only regarded as a need because the nicotine forms an unnatural habit-forming dependency or appetite in the minds of its users. It quietly reprograms the brain of smokers, writing the "need" for tobacco into their whole psychology... (Hence all the vitriolic comments on this thread from the otherwise "generous" smokers you're talking about.)

If you want to quit smoking good for you. If you don't wanna quit smoking that's great too. The religious zeal with which so many attack the smoking issue is insane to me. There really isn't any credible data which shows a definite link between smoking and cancer. There's isn't even any that can show a define link between 2nd hand smoke and cancer. This is why the American Cancer Association will never say if you smoke you will get cancer. They always use the qualifier 'may' when speaking on this topic. Fact is there are plenty of people who have been life long smokers who NEVER developed cancer. Also, there are plenty of lifelong non-smokers who develop lung cancer and other cancers traditionally attributed to smoking.

Number 1) The American Cancer Association will gladly tell you that the risk of cancer is greatly exacerbated when coupled with smoking.

Number 2) As the child of a parent who has severe asthma, I can say with certainty that her asthma was tripped every time she was around second hand smoke!

Number 3) Smoking most certainly causes emphysema, a disease that's both crippling and expensive to treat.

Number 4) Smoking is very clearly linked to numerous other diseases.

I'm not saying we need to ban smoking. But to say, like you implied, that smoking is harmless, is pure bullshit. Smoking is also a tax on public health, and as such, smokers should pay more for healthcare insurance. Smoking is a known risk, a risk that people should be able to take upon themselves in a free society, but a risk none the less. Excessive taxation is not the answer, black markets will always appear when legit markets fail.

Yes really. You don't get something pretty damned obvious. Fact is there are LOTS of people who smoke and don't come down with anything. That pretty much makes it impossible for anyone with credibility to make the claim that smoking w/o a doubt causes cancer and will kill you. There is a genetic component to cancer and these other diseases you are trying to you are ignoring. I can't smoke because I'm asthmatic so no shit I can say w/o a doubt that smoking will kill me if I started. In the end this whole debate comes down to personal freedom. Let's be honest here. Tobacco isn't as dangerous as people like you claim/believe it is. cuz if it were it would be as illegal as weed is. Hell, I'm still amazed by the fact that alcohol is legal yet weed isn't because there is concrete proof that alcohol kills MANY people each year and many of those are innocents. Anyway, go show me where a medical professional tells us that smoking will w/o any doubt lead to those sicknesses and that smoking is the ONLY way those sicknesses are contracted. No one will tell you that because it's untrue.

Ignorance. It's not a disease!

Do please note that I didn't claim smoking causes cancer! I said, as does the American Cancer Association , that smoking exacerbates cancer!

However, logic fails upon guys like you. So, I'll take the easy way out and say - fuck you.

People should have their freedom. At the same time, my insurance premium shouldn't rise because you want to smoke! Get the fuck over yourself!

Fact is there are LOTS of people who smoke and don't come down with anything. That pretty much makes it impossible for anyone with credibility to make the claim that smoking w/o a doubt causes cancer and will kill you.

I smoked for about 18 years before quitting for good about 5 or 6 years ago. I quit because I needed to, not because of the tax hikes or making it increasingly difficult to purchase and use cigarettes.

The solution does not lie in turning smokers into criminals or prescription patients, that will just create another illegal drug problem. It lies in education and a visit to a hospital ward.

For me the eye opening moment was lying on a hospital bed with a sports injury (of all things!) in a ward filled with older people on ventilators pissing and coughing up blood. I was able to get up and walk out 24 hours later, none of the other people there will have been able to return home and sleep in their own bed.

I'm not smug about having quit and I do miss smoking. I've probably screwed my chances but I won't be taking up smoking again.

As a footnote: I lost my Uncle last year to smoking related illness just as he was looking forward to retirement. A life long smoker, he spent his last weeks in a hospital bed, just like those other poor bastards that shocked me into quitting.

Yes really. You don't get something pretty damned obvious. Fact is there are LOTS of people who smoke and don't come down with anything. That pretty much makes it impossible for anyone with credibility to make the claim that smoking w/o a doubt causes cancer and will kill you. There is a genetic component to cancer and these other diseases you are trying to you are ignoring. I can't smoke because I'm asthmatic so no shit I can say w/o a doubt that smoking will kill me if I started. In the end this whole debate comes down to personal freedom. Let's be honest here. Tobacco isn't as dangerous as people like you claim/believe it is. cuz if it were it would be as illegal as weed is. Hell, I'm still amazed by the fact that alcohol is legal yet weed isn't because there is concrete proof that alcohol kills MANY people each year and many of those are innocents. Anyway, go show me where a medical professional tells us that smoking will w/o any doubt lead to those sicknesses and that smoking is the ONLY way those sicknesses are contracted. No one will tell you that because it's untrue.

Someone doesn't understand statistics and risk.

Driving while intoxicated also doesn't mean that you will necessarily get in a car wreck. You can't point to a drunk climbing into a car and say, without a doubt, that he will crash his car on the way home.

But it is much more likely that he will crash his car on the way home than a person who is not drunk. And smokers are much more likely to get certain types of cancer than people who don't smoke. People who play russian roulette are much more likely to die of a gunshot wound than others, for that matter.

It doesn't matter that you can't say, with 100% certainty, that smoking *will cause* death, that drunk driving *will cause* an accident, or that russian roulette *will cause* death. You are the only person bringing up this strawman argument, and, well...it's just stupid.

This is a pretty bad idea. Smoking is already so heavily taxed that there's a huge smuggling market. I've never been a smoker but even I know exactly where to buy cigarettes at half the price of retail.

I personally hate smoking. I won't date a smoker and won't party or associate with them. I had 4 uncles and 2 pairs of grandparents that died early because of smoking's complications.

The obvious impact of smoking is on medical or health insurance costs. Force smokers to buy enough health insurance to cover their medical costs. It's not fair for the rest of us to have to pay their medical bills. That's where enforcement needs to be applied. People should be offered cheaper insurance rates if they pass a nicotine test every 6 months or so. The insurance companies can easily identify the smokers or those that live with smokers. (Second hand smoke is nearly as bad.) OSHA can outlaw smoking in the office or factory if they haven't already. Most public places now outlaw smoking at least indoors. I don't frequent bars or casinos, the two main places where smoking seems to be still allowed so I should easily pass the "smoke test".

A nicotine test is rediculous. What about Nicorette? Or those electronic cigs?

Yes really. You don't get something pretty damned obvious. Fact is there are LOTS of people who smoke and don't come down with anything. That pretty much makes it impossible for anyone with credibility to make the claim that smoking w/o a doubt causes cancer and will kill you...Anyway, go show me where a medical professional tells us that smoking will w/o any doubt lead to those sicknesses and that smoking is the ONLY way those sicknesses are contracted. No one will tell you that because it's untrue.

Do you want to be shown a medical professional saying that smoking always leads to disease? That would be a straw man because no-one claims that it's guaranteed to cause you harm. If what you really want is to be shown evidence that it definitely increases your risk of disease, that's much easier because it has been the scientific consensus for decades.

Maybe you just misunderstand risk. Any given person has a baseline risk of cancer if they don't smoke - it can never be 0%. If that person does smoke, their risk of getting cancer massively increases - but not to 100%. Hence, smoking causes cancer and kills people. However, smoking is not guaranteed to cause cancer in that given person and kill them.

Edit: Also the WHO. Or just for fun, go to PubMed, then come back and say that medical professionals don't think smoking is a big deal for health.

"The proposal to require licences will inevitably be widely perceived as demeaning, onerous, and punitive, and in explicitly targeting smokers would dramatically exacerbate the sense that smoking 'just has that sort of feel about it, a leper.'"

Isn't that kinda the point?

Also, yeah, the black market would quickly fill the gap. People already smuggle cigarettes to avoid taxes and this would be no different.

Finally, I've always be impressed with how generous smokers are with other smokers. If a smoker goes up to another, total stranger, and asks for a cigarette, 9 times out of 10 they will comply. I mean, you wouldn't go up to a total stranger and ask if they can spare a sandwich, but asking for a cigarette is somehow socially acceptable. I wonder if having a monthly quota on your "smart card" would break that feeling of comradeship between smokers.

How about we try a more comparative example... go up to someone and ask for a quarter, 9 times out of 10 if they have it they will give it to you.

Calling the tobacco tax hugely lucrative for the government is disingenuous. The amount of revenue collected from the tobacco tax is less than 1% of total tax revenues. And what revenue is collected is largely a zero sum game as it mostly goes to offset the public health costs smokers create.

Are you sure about that ? Where I live tobacco taxes are 9 billion revenue for government each year.

Even if the cost of every EPOC, cerebral vascular accident, cancer, and asthmas in the country were due to tobacco, the government would have 6 billion to spare.

And we have universal public health so if you have cancer 100% of the treatment expenses goes to Government - I mean it's not the are getting the money and people have to go to private hospitals, the tobacco taxes covers for it all.

Additionally, most people try to ignore the enormous taxes/penalties Tobacco companies pay outside of the specific taxes on a pack of cigarettes.

Tobacco companies pay their way and then some. I think people just need a cause to rail against. The USSR fell, there are no clear and present enemies(I suppose some might say Iran or China, but it's definitely murkier) and now tobacco is great scapegoat for people to attack for whatever reason.

I'm not pro-tobacco, but I'm definitely anti-anti-tobacco. The anti-tobacco zealotry is out of hand in my opinion.

Note the study comes out of Sydney. Here in Australia we already have the highest taxes on tobacco of any nation (an average packet costs US$20+, yes a $1 per cigarette!) . The Government has now banned smoking on beaches, parks, and just about every place people socialize, indoor or out. Smokers here face a strong stigma from the "holy-er then thou" critics, who have won just about every argument over the issue.

For example Australia is also the first country in the world to introduce plain packaging, where logo's, trademarks or even colors are NOT permissible on the packet. This is what all packets now look like in Australia: http://www.scilogs.com/import-data/imag ... kaging.jpg

Given the pace and veracity with which the Australian Government has enacted anti-smoking initiatives to date, it would not surprise me in the least if this is adopted in Australia relatively soon. As we do not even have a requirement of evidence a tactic will work before pursuing it (like plain packaging).

My issue with the whole anti-smoking movement is; when do we start addressing the other issues that cause immeasurable harms: - Alcohol- Obesity- Problem gambling

All of which are as deadly and harmful to society as smoking is. As smoking has declined use of these vices have increased as people looked to fill the void.To the point where Australia is now on par with the US as the having most obesity populace in the world. We also have major issues with alcohol (violence) and problem gamblers (we have the largest number of gaming machines per capita in the world).

As smoking has gone down the waste-lines have gone out in synchrony. All it has achieved is a shift in the problem, instead of dying of cancer most will now die of heart disease or some other obesity related condition.

Finally a personal observation: I've never met an obese person over the age of 75 but I've known quite a few smokers who lived well past 90.

When will gub'm'nts get it? Making a desired product illegal or raising the costs to obtain will do Nothing to stop the use/sale of that product. It will instead, always and inevitably, create a black market product that is highly valuable and make evil (yes, even more evil than you bureaucrats and politicians) insanely, filthy, stupidly rich.

Hmm, should we implement this for criminalized drugs and abortion, too?

People are going to do what they feel is necessary with their own bodies, whether that consists of continuing a harmful addiction or killing a trespassing life form. Rationalization can trump legality, morality, and health concerns any day of the week.

This proposal is a step towards criminalizing another addiction - historical precedent demonstrates that the "war on ___" approach is an ineffective solution, and any progress made will accompany corresponding (and disproportionate) harm. We cannot disregard the effects of the black market.

I'm sorry, but I have to reply to the "Make them pay! Why should we subsidize their health care?" bunch.In my home province, the anti-smoking zealots love pointing out that smoking supposedly costs us an additional 1.5 billion dollars in healthcare. They always forget to also note that the taxes paid on cigarettes add over 3 billion to the provincial economy, netting a profit of 1.5 billion.There's a reason that governments haven't banned smoking... It's because they've crunched the numbers repeatedly and found that it's lucrative to society. Same reason that drinking and gambling are legal.

I have approximately 85 local currency to survive on per month. I also have a 5 year old child to support.

She eats well, 3 times a day. Unfortunately i don't. It is cheaper to smoke, less than 1 LC ,a day than to eat. I have been having to live like this since the beginning of this year.

I also never smoke near her. >75% of smokers witnessed a parent smoking.It is also driving me to an early grave. I recently collapsed and had to be taken to hospital. Diagnosis. Stress and a deficient diet. No shit sherlock.Prescription. Lots of medication and not to work for 2 weeks.Both impossible to afford.

So when at 10 in the morning i take a long pull on a rollup, it is my decision. One of the very few I am master of in my life.

I do not like cigarettes and I have never smoked them. I do however, enjoy an *occasional* pipe or cigar.That being said,

It is about FREEDOM! It someone wants to smoke, let them. If a restaurant wants to allow smoking, that should be the owner/manager's choice as much as the selections on the menu and wine list.

Just as with our electronic addictions, we support selection and choices... Don't like Apple or Microsoft? There is Linux. Don't like the overlay on the android cell phone? Root it. FREEDOM applies to smokers too.

"It is indeed an historical absurdity that so dangerous a product should be so readily available..."

No. What's absurd is the cost to treat the nicotine addicts when they eventually stagger into an emergency room and are notified they have stage 4 or 5 cancer.

Without getting into anything personal, I've seen this first hand. From initial diagnosis to death several months later, the bills (for the largely futile treatments, hospitalization, medication, etc., etc.) approached $1M. And it could have gone much higher. ...For one individual.

Now multiply the costs by the 450,000 who die (needlessly) in the US each year. It's ridiculous.

As are all the arguments for not banning smoking outright. But that's another topic.

I could see insurance companies loving this though since they would have a very easy time identifying smokers and raising their premiums.

Is that a bad thing? If you choose to smoke, why should I subsidize your habit with my insurance premiums?

That sounds great until someone starts poking around in your life deciding what should not be subsidized. Play sports? Why should I subsidize your injuries?Watch tv? Why should I subsidize your lazy lifestyle?Like to drink? Why should I subsidize your alcohol fueled binges?Eat out? Why should I subsidize your unhealthy choices?

I'm going to make a killing selling my quota on the black market. Seriously, this article doesn't even pretend to address the obvious holes in their scheme. It's a terrible article.

FTFA:

Quote:

Chapman is not so naïve as to think there would not be a minor public outcry from smokers and sceptics alike, so although he touches on issues such as black market up-take, he has also asked Jeff Collin, political scientist and director of the Global Public Health Unit, to respond.

If you are really interested, you can go read both articles. This is a summary, not a detailed blow-by-blow.

If the obvious deficiencies in the plan were covered in depth in the original source material, then that just makes this article even shittier than it already is.

If cigarette smoke didn't stink and make my throat sore from 50 yards away when the wind is blowing in the wrong direction (and, spoil my enjoyment of the fresh air);

Some pretty sensitive lungs you have there

Quote:

or, if smokers had the sense NOT to smoke in/near childrens playgrounds, or at school gates, or at the entrances of buildings (with their smoke blowing straight inside with the draughts from the air conditioning);

Can't speak for people who frequent playgrounds, I mainly smoke outside building entrances when the legislation which forces me to smoke outside doesn't also force the building owner to provide a designated smoking area

Quote:

or, if the national health services of many countries weren't effectively robbing non-smokers & delaying/cancelling THEIR medical services so as to subsidise instead the post-hoc treatment of others who "chose" to smoke & consume a "product" that kills half of its customers before they die a natural death;

Got any citations for this bit?

Quote:

then I might accept the suggestion that this was about smokers' rights not to have their preferences interfered with. As it is, I am rather inclined to feel that they are infringing upon my "preferences" for my children not to breathe the air from those cancer-sticks, and for them not to be shown such a bad example at close range.

I'd be intrigued to see your views if it was, for example, something which affected your right to stink of booze and set a bad example to other people's children (please note this is an example, not an accusation). Besides, as a parent isn't it your responsibility to educate them against the dangers of the example they are being set, rather than the responsibility of the smoker to avoid being a bad example for the children of strangers?

I think it's a terrible idea because it's simply not the government's problem.

The only way I would support it is if all adverse conditions are similarly taxed. Red-meat heavy diet? Increased chance of heart problems. Vegan? Increased chance of lower-digestive cancer. Run? Knee and hip problems.

Or what about known but involuntary risk-factors? Should fair-skinned people have to pay more because they're more susceptible to skin cancer? Or dark-skinned because they're more likely to suffer some vitamin deficiencies?

I could go on, but the point is this is a step I really, really would prefer not to see the government take. It's also the main objection I have to federal healthcare; it lets the government decide what's unacceptable today.

I am against smoking. I had a grandfather who died from lung cancer when he was in his 60s. He did not live to see me graduate from high school. My grandmother, his wife, had chronic emphysema and spent the last 5 years or so on an oxygen machine. She died older, but did not live a happy life after her husband died. She basically just died. Finally decided she didn't want to fight any more and that was it. There was not a direct connection between her death and smoking, but she smoked until she fell ill. It was a factor.

That being said. This card takes matters a step in the wrong direction. As much against smoking as I am, I am against the violation of civil liberties even more. What will that card be linked to next? Alcohol?

I am not a heavy drinker. I may have a mixed drink or a beer occasionally, but I rarely drink, and drink to excess even less. But, I may go to a gathering that's BYOB. If I bring any, I share some, drink some, but almost always take some back. I have 5-6 bottles of alcohol about 75% full in my cupboard. I don't buy cheap liquor, usually. I already pay a premium on alcohol as it is. I would not want this to affect me. None of my potential health issues are related to the consumption of alcohol.

Alcohol, (wine) can even be healthy in small doses, due to flavinoids, antioxidants, and other ingredients. Beer used to be a drink used for nutrition. It was a liquid that quenched thirst and provided a meal, due to wheat or barley. It can also contribute to breast enlargement because of the yeast content--although the amount of beer needed to produce a noticeable effect is staggering. Point being, most alcohol is not without redeeming qualities, when used in moderation.

The only redeeming quality of the tobacco plant is that nicotine can be used as a pesticide.

Tell that to people who need full time care due to emphysema or other lovely diseases. A lower lifetime does not mean lower health care costs. There's a reason insurers have bean counters!

This is why insurance companies have actuaries in addition to "bean counters". Or are you proposing health insurance policies that exclude coverage for ailments merely because they're strongly corollated with particular "lifestyle choices"? Smoking is nothing — consider bloodborne pathogens that mostly spread via unsafe IV drug use, and how such a policy would affect healthcare workers, say, or patients who receive the rare contaminated human blood product from a supply that is 99.999% safe. Suppose the probability that one is a heavy IV drug user given that one is infected with pathogen X is greater than the probability that one is a heavy smoker given that one has, say, emphysema. Do we then exclude "pathogen X" from insurance coverage, or require healthcare workers and hemophiliacs to take weekly "heroin tests" to maintain coverage? And if the latter, who pays for the expensive testing?

I could see insurance companies loving this though since they would have a very easy time identifying smokers and raising their premiums.

Is that a bad thing? If you choose to smoke, why should I subsidize your habit with my insurance premiums?

That sounds great until someone starts poking around in your life deciding what should not be subsidized. Play sports? Why should I subsidize your injuries?Watch tv? Why should I subsidize your lazy lifestyle?Like to drink? Why should I subsidize your alcohol fueled binges?Eat out? Why should I subsidize your unhealthy choices?

Sounds good to me. That's how subsidies work.

Don't like it, then hate capitalism! Because if you think insurance companies don't work like this already - you're a total fool!

"The proposal to require licences will inevitably be widely perceived as demeaning, onerous, and punitive, and in explicitly targeting smokers would dramatically exacerbate the sense that smoking 'just has that sort of feel about it, a leper.'"

Isn't that kinda the point?

Also, yeah, the black market would quickly fill the gap. People already smuggle cigarettes to avoid taxes and this would be no different.

Finally, I've always be impressed with how generous smokers are with other smokers. If a smoker goes up to another, total stranger, and asks for a cigarette, 9 times out of 10 they will comply. I mean, you wouldn't go up to a total stranger and ask if they can spare a sandwich, but asking for a cigarette is somehow socially acceptable. I wonder if having a monthly quota on your "smart card" would break that feeling of comradeship between smokers.

How about we try a more comparative example... go up to someone and ask for a quarter, 9 times out of 10 if they have it they will give it to you.

Go ahead and try. I think you'll find 9 times out of 10 they tell you to go fuck yourself.

Of course, this requires an actual experiment, but I'm pretty confident that you'll find more smokers will give another smoker a cigarette than a non-smoker giving a stranger a quarter.

I think we've done all that can be reasonably done to curb smoking without being too intrusive into civil liberties. Indoor smoking bans do a lot to prevent innocent bystanders from being affected by smoking and heavy taxes have done a lot to reduce smoking and help pay for the increased costs to society incurred by people who choose to smoke. We've made it as easy as we can to do the right thing, you can't expect people to always do what you want or what is best for them all the time and we should have the liberty to make bad choices from time to time.

This is a problem that's as solved as it is ever going to be, its time to move onto another more pressing issue such as obesity. We can do a lot to incentivize healthy eating without banning anything or reducing liberty by taxing unhealthy foods and reducing portions which will reduce the costs to society incurred by people who choose to overeat. If the easiest and cheapest option was the healthiest one then society will be better off.